Park Villa Nursing and Rehabilitation Center LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

1980551 Issued in IL

Legal business name

PARK VILLA NURSING AND REHABILITATION CENTER LLC

Practice address

12550 S Ridgeland Ave
Palos Heights, IL 60463-1859

Phone

(708) 597-9300

NPI assigned

Nov 30, 2010

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Menachem Berger

Title

Manager

Phone

(847) 440-2660

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1291075200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619481600000",
    "number": "1255633012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7040 N RIDGEWAY AVE",
            "city": "LINCOLNWOOD",
            "state": "IL",
            "postal_code": "607122620",
            "telephone_number": "847-679-9797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12550 S RIDGELAND AVE",
            "city": "PALOS HEIGHTS",
            "state": "IL",
            "postal_code": "604631859",
            "telephone_number": "708-597-9300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK VILLA NURSING AND REHABILITATION CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-30",
        "last_updated": "2021-04-27",
        "certification_date": "2021-04-27",
        "status": "A",
        "authorized_official_last_name": "BERGER",
        "authorized_official_first_name": "MENACHEM",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "847-440-2660"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IL",
            "license": "1980551",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Skilled Nursing Facility in Palos Heights, IL
• Providers in Palos Heights, IL by specialty
• Skilled Nursing Facility in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.